Letters To The Editor
Copyright ©2014 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Jan 7, 2014; 20(1): 330-332
Published online Jan 7, 2014. doi: 10.3748/wjg.v20.i1.330
Digestive tract reconstruction pattern as a determining factor in postgastrectomy quality of life
Xin-Zu Chen, Wei-Han Zhang, Kun Yang, Jian-Kun Hu
Xin-Zu Chen, Wei-Han Zhang, Kun Yang, Jian-Kun Hu, Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Author contributions: Chen XZ wrote the letter; Zhang WH contributed equally to present letter; Yang K contributed to literature retrieval; Hu JK reviewed the letter.
Supported by The National Natural Science Foundation of China, Nos. 81071777, 81372344 and 81301866, and the Scientific Research Program of Public Health Department of Sichuan Province, China, No. 120196
Correspondence to: Jian-Kun Hu, MD, PhD, Professor, Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang Street, Chengdu 610041, Sichuan Province, China. hujkwch@126.com
Telephone: +86-28-85422878 Fax: +86-28-85164035
Received: September 6, 2013
Revised: October 14, 2013
Accepted: October 17, 2013
Published online: January 7, 2014
Processing time: 136 Days and 13.3 Hours
Abstract

Postgastrectomy quality of life (QoL) is affected by various symptoms, and compared with the preoperative baseline QoL, is typically impaired for the first 6 mo after surgery. Thereafter, improvement to a stable QoL is observed at approximately 12 mo postoperatively. We consider the digestive tract reconstruction pattern to be a determining factor in postgastrectomy QoL among gastric cancer patients, and believe it requires further discussion. Proximal gastrectomy is associated with the worst postoperative QoL among gastrectomy procedures and should be performed cautiously. The trend of better QoL provided by the pouch procedure of total gastrectomy requires further robust support. Whether the use of Billroth-I gastroduodenostomy or Roux-en-Y gastrojejunostomy for distal gastrectomy is optimal remains controversial, but Roux-en-Y gastrojejunostomy is likely to be preferable.

Keywords: Gastric cancer; Gastrectomy; Quality of life; Reconstruction; Digestive tract

Core tip: Proximal gastrectomy is associated with the worst postoperative quality of life (QoL) and should be performed cautiously. The trend toward better QoL following the pouch procedure of total gastrectomy requires further robust support. Whether the use of Billroth-I gastroduodenostomy or Roux-en-Y gastrojejunostomy is optimal for distal gastrectomy remains controversial, but the Roux-en-Y gastrojejunostomy is likely preferable.